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Pediatric Coding Alert

Reader Questions:

Include Supporting Symptoms for Metabolic Test

Published on Sat Mar 27, 2010

Question: A locum tenens who filled in while our pediatrician was out of the office noted "metabolic screening" on the patient's chart. What's the best diagnosis for a metabolic screening, and do we need to include additional diagnoses as support? Washington Subscriber Answer: ICD-9 includes two codes for metabolic screening: V77.7 (Special screening for endocrine, nutritional, metabolic, and immunity disorders; other inborn errors of metabolism) and V77.99 (... other and unspecified endocrine, nutritional, metabolic, and immunity disorders). Choose between these codes for your first diagnosis, based on the reason for testing. Add to it: Bolster your claim by including codes for other symptoms the physician included in the chart. For example, symptoms such as lethargy (780.79, Other malaise or fatigue) or low weight gain (such as 783.41, Failure to thrive) might indicate the need for hypothyroidism screening.
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